A few weeks ago, I shared this post on intuitive eating and IBS where I discussed what IBS is, and intuitive eating vs. elimination diets/food avoidance as a treatment strategy. If you haven’t read it, I hope what you’ll find is a nuanced discussion of the risks and benefits of different ways of approaching managing IBS symptoms.
Todays post will focus on specific non-diet tips and strategies for reducing or coping with IBS symptoms. As I mentioned in Part 1, there may be some cases where dietary avoidance is indicated, but with today’s post, I want to highlight ways to target symptoms without resorting to eliminating foods. If you are considering any type of elimination diet, like low FODMAPS for example, I highly recommend working with a dietitian who is experienced with it, and making sure it’s someone who is mindful of your emotional needs while taking such an approach.
Deep breathing/meditation before eating.
As I mentioned in part 1, there is a strong relationship between anxiety and IBS. A stressed person will likely have a stressed gut. This is especially important to note for anyone who has struggled with disordered eating, or feels anxiety/fear around eating certain foods. For example, is it the gluten/dairy/sugar causing symptoms, or is it the anxiety around eating gluten/dairy/sugar?
It can be helpful to give yourself a moment for deep breathing or meditation before eating. This may vary based on where you’re at. Perhaps some days at home, you’ll have the time and space to lay out your yoga mat, and do a 5-10 minute meditation. Other days you may be at work or out to dinner with friends, so quietly taking a few deep breaths may be more appropriate.
Aim to eat every 3-4 hours throughout the day.
Nothing triggers IBS symptoms like chaotic eating. Eating on an irregular schedule, going long periods of time without eating, then eating larger amounts, in my experience causes a lot more discomfort than any individual food. While there’s no need to follow a strict eating schedule, having a consistent flow with eating is helpful, as it gives your gut a chance to get into a rhythm. There may be a temptation to skip meals or snacks when your stomach is upset, but eating consistently helps to promote gut motility.
Aim for balance at meals.
And by balance, I mean including a source of protein, fat, carbohydrate and produce. Similar to as I described above, by aiming for balance at meals, it allows your body to expect consistency in how you’ll be feeding it. It is also helpful for ensuring you’re fueling your body adequately so you’re not overly hungry before your next meal/snack.
Try gut-directed hypnotherapy.
Gut-directed hypnotherapy is a kind of hypnotherapy, but for the gut. Sounds kinda “woo,” but there is research showing that it can reduce symptoms by up to 80%, and is similarly effective to low FODMAPS. Here’s a helpful article on the treatment if you’d like to learn more. Here’s a list of providers who are trained in gut directed hypnotherapy, or check out the Mind + Gut or Happy Inside app.
There are a TON of supplements out there that get thrown at people at IBS. I’m pretty cautious about recommending supplements, as often they aren’t backed up by rigorous research, and can do more harm than good. Just because something is natural doesn’t mean it’s harmless. Most medications originally come from a natural source, and if something has a physical effect on your body, that means there’s going to be potential side effects.
Still, there may be some supplements that are beneficial. Below are some that I often recommend/use in my practice. These are not individual recommendations, and if you do choose to try a supplement, please do so under the guidance of your doctor or a dietitian with experience in IBS.
Probiotics - Different probiotics do different things, so do some research on the strains in the brand you’re purchasing. The clinical guide to probiotics is helpful.
Iberogast - Iberogast is a liquid supplement made from plant extracts that’s helpful for promoting gut motility,. I like it for those who experience gas, bloating and abdominal pain as a symptom.
Atrantil - Atrantil is a supplement that targets methane producing bacteria in the gut, and can be helpful for some people with small intestinal bacterial overgrowth (SIBO)
Fiber supplements - Be careful about what types you use. Fermentable fiber supplements, often marketed as prebiotics, can cause painful bloating for IBS sufferers. Focus on soluble fibers, like psyllium, which form a gel in liquids that can make stools easier to pass while providing bulk.
Consider fermented foods.
Fermented foods are sources of beneficial probiotic bacteria. Although probiotics can provide therapeutic doses of specific strains, in general, I prefer fermented foods which provide a wider variety of bacteria strains. Plus, you’re more likely to get live bacteria, as it’s being consumed along with the bacteria’s food source. Examples of fermented foods are yogurt, kefir, miso, kombucha, kimchi, sauerkraut, and some vinegars. If you want to try your hand at home fermenting, here’s a post I did sharing three recipes for fermented veggies.
Tune into hunger and fullness cues.
Overeating doesn’t feel good for anyone, IBS or not. Learn to tune into hunger and fullness cues, so you’re better able to honor your hunger before you’re ravenous, which makes it easier to stop eating at a place where you feel satisfied, but not stuffed. Here’s a post I wrote on tuning in to hunger and fullness.
Get adequate sleep.
Don’t underestimate the importance of getting adequate sleep for IBS. A poor night of sleep can especially impact IBS symptoms in the morning. Practice good sleep hygiene by trying to get to bed about the same time, and consider starting a nighttime routine. I’ve also been loving having natural sounds playing at night with the Naturespace or White Noise app, which also drowns out my snoring Saint Bernard.
Go to therapy, and consider medication.
If your IBS is related to anxiety (if you have IBS and anxiety, there’s at least some level of connection there), trauma, or both, consider therapy if you have access to it. There’s also nothing wrong with using medication to help treat anxiety, and some have been shown to improve IBS symptoms as well.
Try yoga for digestion.
Yoga can be helpful both for it’s stress relieving benefits, and to help promote gut motility and reduce IBS symptoms. Consider movements that stretch, twist or compress the abdomen, as this helps improve blood flow to the gut, and keeps gut contents moving along. I often do this quick video from Yoga by Adrienne. I also find happy baby and child’s pose soothing when my stomach is upset.
Consider gentle movement vs vigorous movement.
Exercise is helpful for IBS, but vigorous, sustained exercise can exacerbate symptoms. I’m sure my runner readers are familiar with runners trots - that would be a perfect example! Consider replacing intense exercise with more gentle types of movement and seeing if that reduces symptoms. Check out this post on gentle movement I’ve been loving lately for some ideas.
Purchase a squatty potty.
If you struggle with constipation or incomplete bowel movements, try a squatty potty, which is a kind of stool you can place in front of your toilet to raise your feet when you go to the bathroom. This allows for you to better access your gut muscles for more complete bowel movements.
I should also mention that it can be helpful to just eat a little healthier too. If you’re eating a diet that doesn’t have a lot of fiber-rich fresh foods, that can contribute to symptoms (especially constipation). That doesn’t mean eliminating foods or following a strict diet, but gentle nutrition practices can go a long way.
Generally speaking, I think it’s useful to look at these tips and strategies before turning to dietary elimination. I hope this post shows you that there’s a lot we can do to find relief without cutting out foods or following a strict diet! I also highly recommend working with a dietitian who is voiced in IBS and intuitive eating. I work with clients virtually throughout the US, or would be happy to send you a recommendation in your area of I know of anyone.
Now, I would love to hear from you. If you suffer from IBS, what non-diet strategies have been most helpful for you?
You might also like: